Thanks, Dr. Fauci!

Perhaps the most famous NIH staffer right now is Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases (NIAID), and one of the leading voices throughout the COVID-19 pandemic. Prepared by more than 50 years of government service and research on infectious diseases, Dr. Fauci is a public servant who brings reason, expertise, and a keen sense of how to mobilize the public health sector to act against this unprecedented threat to public health.

Like many others around the country and the world, my family and I think of Dr. Fauci as “our doctor.” He speaks to us, giving a personal response to ensure the public’s health. He understands the challenges of having family at a distance during times when travel and family gatherings are discouraged to reduce the spread of infection. He shares the joys of those reunions—full of hugs from family and friends—so long missed. It’s amazing to me that Dr. Fauci has been able to convey such warmth and concern to the world and be the deliverer of trusted knowledge in such a personal manner. More than once, conversation at a family dinner or on a family phone call has included the question, “But what does Dr. Fauci think about . . .?” followed by heartfelt wishes of gratitude from my mother and siblings!

I am privileged to be part of the NIH leadership team who meets weekly to advance the mission of the world’s largest research enterprise. While we address wide ranging issues from advancing biomedical science to NIH infrastructure and operations, discussions about NIH’s response to the COVID-19 pandemic still dominate. Like others, I find Tony a wise and experienced colleague, thoughtful in his contributions, and quick to bring a sometimes much-needed touch of humor into complicated conversations. I marvel at his stamina and the breadth of issues that engage his mind.

Tony Fauci has built a superb team of scientists, clinicians, and administrators within NIAID. The dedication and intellectual generosity evident in his contributions to our efforts are evident across NIAID – clearly an inspirational leader motivates and inspires!

So please join me in expressing gratitude to my colleague, Tony Fauci – a national treasure!

Nursing and Libraries – Powerful Forces in Motion

This month, NLM joins the Nation in celebrating Black History Month. Libraries play an important role in ensuring equity of access to information. From my career as a nurse, I know that libraries are important vehicles for delivering trusted information. To celebrate my dual allegiances to nursing and libraries, in this post, I am tuning into the voices of Black nurses to learn what libraries mean to them.

Black nurses have made huge contributions to the health and well-being of people and are foundational to the health care system as we know it today. Rhetaugh Dumas, PhD, RN, a psychiatric nurse and academic leader, once served as the deputy director of the NIH’s National Institutes of Mental health (1979-1981). Another psychiatric nurse, Chester A. Woffard, III, MSN, RN was a leading thinker in suicidology, particularly addressing the needs of nurses coping with suicide among colleagues. May L. Wykle, PhD, RN, devised critical intervention strategies for caregivers, with particular attention to self-care needs among minority elders. Loretta Sweet Jemmott, PhD, MSN, RN, is an expert in health promotion and created much of the evidence base for HIV risk-reduction interventions. I’ll bet every one of these nurses used (and still uses) the library often!

I asked some nurse colleagues to reflect on the role libraries have played in their professional and personal lives – and look what I learned!

Linda Burnes Bolton, DrPH, RN, FAAN | Senior Vice President and Chief Health Equity Officer | Cedars-Sinai Health System

Libraries have been my constant go-to place for knowledge and skills to support any task I took on. It was important to me to join a profession that would enable me to read, learn, and be of use to other humans — nursing was the answer to my prayers. Reading in the library and collecting journals from around the world was a way to learn about life, humans, and nurture my sense of purpose to be of use to others. Libraries are full of stories about human caring; they are a safe place to gain knowledge and to explore and imagine life’s possibilities. I treasure my memories of being in the aisles of public and private libraries in schools, after school, and now accessing the wise words and secrets held by libraries electronically.

Sheldon D. Fields, PhD, RN, CRNP, FNP-BC, AACRN, FAANP, FNAP, FAAN | Associate Dean for Equity and Inclusion Research Professor | The Pennsylvania State University College of Nursing

As a healthcare professional who is also a researcher, educator, and health policy specialist, I have leveraged the resources of the NLM many times. As an HIV prevention research scientist, I rely heavily on the biomedical literature databases such as PubMed to keep up to date on the research literature and for dissemination of my own work. As a nursing educator, the NLM training resources and courses on how to use various databases, as well as resources such as MedlinePlus and DailyMed for drug information have been most beneficial in my work with nursing students. The NLM supported National Information Center on Health Services Research and Health Care Technology is also a reliable source for all things health policy related. Having such reliable, up to date, and accessible resources from the NLM is critically important to all facets of my career. 

Paule V. Joseph, PhD, MS, FNP-BC, CTN-B, FAAN | Lasker Clinical Research Scholar Tenure Track Investigator | NIH Distinguished Scholar | Acting Chief, Section on Sensory Science and Metabolism Unit (SenSMet) | Division of Intramural Clinical and Biological Research (DICBR), National Institute on Alcohol Abuse and Alcoholism (NIAAA) | Biobehavioral Branch, National Institute of Nursing Research (NINR)

During my PhD program, I realized how critical the library and librarians were in my scientific journey. The librarian at the UPenn Biomedical Library — who was also a nurse — played a crucial role in my PhD trajectory. It was the first time I had met a nurse who was also a librarian, and her intimate knowledge of nursing and the scientific literature helped me a lot. In my role as Principal Investigator, the librarians at NIH have been integral to the development of my lab as I have developed my clinical protocols and conducted literature searches for systematic reviews and meta-analysis. I have even co-authored papers with them. In addition, they are always available to train and share new tools to streamline the research process. The librarians have been very helpful in teaching the fellows and students in my lab about databases and guidelines to conducting reviews. When COVID-19 started and reports about COVID’s toll on taste and smell began to emerge, the NIH librarian (who knew what my lab studied) reached out and helped us tremendously by curating the literature on that topic. I am still using those resources as I develop a COVID-19 taste and smell long-hauler study.

Beverly Malone, PhD, RN, FAAN | President and CEO | National League for Nursing

As a nurse working on my doctorate, I had the opportunity to spend a summer in Washington, DC working with a Senator on many health-related issues. During that time, the Library of Congress became my refuge as I worked on my dissertation section on leadership and mentoring. Resources from the Congressional Library helped me understand the power of mentoring and recognize that nurses were sometimes left behind in terms of the mentoring process. Throughout my career, I’ve been inspired by the graciousness and generosity of spirit in people saying, “I see something in you that perhaps you can’t see in yourself.” But I know that I have been able to recognize this through what I learned at that beautiful, wonderful place called the Congressional Library. The library is where the literature revealed secrets to say, “Look at how fortunate you are to have been mentored all of your life.”

Monique Powell, MSN, RN | Nurse Manager, Cardiac Intensive Care Unit | Children’s National Medical Center

I think back on my freshman year at Howard University and one of the most memorable moments occurred in the Founders Library. I remember the first time I walked through the doors I felt this incredible sense of belonging and history. The library was named Founders in honor of the 17 men that help to found Howard University. This building holds an incredible collection of history for African Americans, and I felt privileged to be able to sit down at the tables and walk through the stacks of books. I had an assignment to research how the African American community has interacted with the medical community. As I researched this topic and used the microfiche machine to view documents, papers, and letters, I remember feeling that I had access to history in a way that I never had before. I remember coming across a personal check signed by Ruby Dee and Ozzy Davis sent to the Howard University School of Medicine to support the students — a piece of history that still moves me so many years later. My experience that day has stayed with me and encourages me to continue the work I am doing in health care and for my community. I am a proud graduate of an Historically Black College and University and feel honored to be able to serve my community as a nurse.

Asia L. Reed MSN, RN, CPN | Professional Development Specialist | Nursing Education and Professional Development | Children’s National Medical Center

The library has helped shape my educational destiny in so many ways. I have appreciated the academic library both online and in-person throughout my undergraduate and graduate nursing programs. The library offers free educational resources, caters to specific research needs, provides space for meeting with others, and supports personal and professional growth. Having recently graduated with my master’s degree in nursing education, the library contributed to my success by providing access to a variety of education resources and online databases that supported my needs. The articles I chose were directed toward my learning styles, which had a positive impact on my academic achievements. As a novice nurse educator, the library continues to play an important resource in my career path and for my pediatric nurse residents.

Reneè Roberts-Turner, DHA, MSN, RN, NE-BC, CPHQ | Director, The Department of Nursing Science, Professional Practice, and Quality Magnet® Program Director | Children’s National Hospital | Assistant Professor of Pediatrics | The George Washington University School of Medicine and Health Sciences

What I always loved most about being in the library is the quiet and calm I felt as soon as I walked through the doors. During my senior year of college, my mentor (who was an employee within the University of Virginia Wise Library) heavily influenced my decision to use my bachelor’s degree in Biology to pursue Nursing instead of medicine. I spent many hours reading about healthcare careers, in various books and journals, reading articles using the microfiche machine, and concluded Nursing was the profession for me. I also spent a significant amount of my time at Marymount University’s Emerson G. Reinsch Library, where I was introduced to the Washington Research Library Consortium and benefitted from the ability to borrow materials from other academic libraries in the Washington, DC area. As I pursued my doctoral degree via online classes, I felt the same satisfaction with the electronic library format. Although I’m not physically in the library, whenever I log on to the electronic library, I still feel a sense of quiet calmness.

Linda D. Scott, PhD, RN, NEA-BC, FNAP, FAAN | Dean and Professor | University of Wisconsin-Madison School of Nursing

Those who knew me as a child can attest that I always wanted to be a nurse. My earliest professional inspiration was Florence Nightingale, whom I mimicked as I provided nursing care to my dolls and even tried to replicate her uniform by wearing a blanket that served as a cape. My information came from books through my neighborhood Bookmobile. An astute Bookmobile librarian noted my hunger for learning and encouraged me to explore more about nursing at the public library. That’s where I learned a more complete history about the nursing profession and discovered a wider representation of nurses, including some who looked like me. Learning about Mary Eliza Mahoney and Mary Elizabeth Carnegie, and later Hattie Bessent and Rhetaugh Dumas—along with other nurses of color whose footprints are evident in the profession—turned my emulation of the nurses I admired into a belief in the possibility for myself. Library resources have not only been invaluable to me throughout my education and career, but they helped me see myself on the “path we tread.”

Ora Strickland, PhD, RN, FAAN | Dean and Professor | Nicole Wertheim College of Nursing & Health Sciences | Florida International University

I remember my parent’s library. It had encyclopedias, short stories, poems, and even medical books. Whenever any of us got sick, my mother would run to her medical books, and I took notice. All those books piqued my interest in becoming a nurse. Throughout my career, I’ve found that university libraries serve nurses very well because the librarians are good. I’ve been fortunate to frequent university libraries where librarians collaborate with the schools of nursing to set up library committees to review the library holdings in health care and related fields to make sure that their holdings are adequate and address the needs of nursing students. One library I have visited often throughout my career is NLM. I’d spend hours and hours at NLM; it’s a wonderful place. I also met some real scholars when I was at NLM. That’s what I miss most with the rise of the internet – because a library is also a community meeting place. It’s a place to meet other wonderful scholars and some of those scholars can end up being collaborators.

Retired Rear Admiral Sylvia Trent-Adams, PhD, RN, FAAN | Senior Vice President and Chief Strategy Officer | University of North Texas Health Science Center at Fort Worth

During my graduate education, particularly my doctoral program, libraries became my lifeline and my “go-to” place to help me problem solve and find resources that I couldn’t identify myself. Librarians gave me ideas that I hadn’t thought of and became my alternate support system outside of my department – and outside of my profession. Libraries have been very integrated into all the work I’ve done and the positions I’ve held throughout my career. Librarians deserve a lot of credit for my academic and professional success.

Mia Waldron, PhD, MSN-Ed, NPD-BC | Nurse Scientist, Nursing Science, Professional Practice & Quality | Children’s National Hospital | Assistant Professor of Pediatrics | George Washington University School of Medicine and Health Sciences

Libraries were a steady feature in my life. I spent childhood summers in the Brooklyn Public Library reading fiction; I worked as a clerk in the Cardozo Law Library as a teen; and decided on the sorority to join based on histories read at the Schomburg Library. The decision to change my college major from pre-medicine to nursing was made after poring over career data found in the health sciences library over 30 years ago. The importance of knowledge, as a nurse, has proven invaluable throughout my career. In most instances, my first instinct is to turn to a library.


What a journey! Libraries are shaping the future of nursing and health care, and these nurses give us a glimpse into how all libraries, including the NLM, resonate with the dreams of nurses and provide support and skills to move forward in practice.

I am grateful to my colleagues for sharing their perspectives, and so proud of what the merging of these two forces — nursing and libraries — bring to the health of the world!

How have libraries influenced you and your career?

Above and Beyond!

As I have said before, I take every opportunity to sing the praises of the 1,700 men and women who work at NLM and demonstrate their commitment to advance our important mission. Every day, NLM staff serve science and society by transforming information into knowledge, which enables researchers, clinicians, and people around the world use a wealth of biomedical data to improve health. 

This month NLM honored our resilient and resourceful staff with an awards ceremony that looked a little different than previous years. Usually, we host an annual ceremony in the Natcher Auditorium on the NIH campus to allow staff to gather and celebrate the accomplishments of their peers.

While our awards celebration was different this year because we weren’t able to join together in person due to COVID-19, it still gave me great pleasure to recognize and honor the many individuals and teams at NLM who have shown outstanding commitment and accomplishment through special acts of service, exemplary performance, and crucial moments of leadership. This year, our awards were presented to honor a variety of achievements, but most notably, to honor the incredible resiliency and productivity of our workforce since most NLM staff entered an environment of maximum telework in March.

Before I share more about the awards, I want to take a moment to extend my deep appreciation for all the technical staff at NLM who have ensured that NLM continues to meet its mission of serving scientists and society across the globe. Our staff has worked tirelessly to make certain that NLM continues to operate throughout the COVID-19 pandemic seamlessly. They’ve done it all – from making sure that all NLM staff can continue to work from home during these challenging times, to guaranteeing that people around the world continue to have access to NLM’s suite of offerings such as ClinicalTrials.gov, GenBank, PubMed, and PubMed Central.

This year, we recognized 584 staff for an array of accomplishments. We honored many individuals and teams for their special acts of service and exemplary performance including the design, implementation, and evaluation of the trans-NLM Data Science @NLM program (recognized as a model program across the federal sector), rapid response to the sharing of molecular data and biomedical literature related to the SARS-CoV-2 virus, and maintenance of library and data center operations in a safe and stable manner during the challenging COVID-19 pandemic.

We applauded staff who provided consistent, results-focused strategic leadership associated with the restructuring of NLM’s more than 8,000-member Network of the National Library of Medicine, launched a new version of PubMed and phase one of the NIH Preprint Pilot. We recognized our scientists who used machine learning and artificial intelligence algorithm research to support infectious disease detection from clinical images, and staff who assisted in delivering technology and administrative support services to ensure the continuity of NLM operations during the COVID-19 pandemic.

We also honored individuals with landmark years of service, including 16 people who have worked in the federal government for 30 years or more. They were joined by 29 staffers with 20 years of service and another 20 with 10 years — representing years upon years of experience and dedication to public service. Their work has made a lasting difference to NLM and to those who use our resources.

In addition to honoring the recipients themselves, these awards also bring important recognition to the talents and contributions of NLM across the biomedical research enterprise.

As the year comes to a close, I want to recognize every member of our team at NLM for their momentous efforts that have kept NLM at the top of our game by demonstrating our ability to be resilient, relevant, and reinvent the way we do our work, particularly in response to the challenges presented by COVID-19. Our team at NLM has truly gone above and beyond!

Guest NLM contributors: Sarah Ashley Jolly, Amy Powers, and Diane Tuncer.

Building Bridges Throughout My Career

Last month, I had the pleasure of hosting a fireside chat with Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID) at NIH and our nation’s top infectious disease expert. This event took place as part of the American Medical Informatics Association (AMIA) 2020 Virtual Annual Symposium and was shared with almost 1,000 AMIA attendees.

I will share a few key points of wisdom that Tony provided a little later in this post, but first I want to share the experience of bridging my life-long affiliation with a dynamic professional society and my current responsibilities as NLM director.

Making Connections

As NLM director, I support the work of the 1,700 women and men who conduct research, enable access to the vast biomedical literature, and accelerate data-driven discovery. I understand the importance of professional societies, like AMIA, that advance the field by nurturing and supporting health information professionals, providing platforms for sharing research findings, and creating spaces that inspire discoveries and improve health through information technologies. Rarely has the critical importance of the field of biomedical informatics been more sharply focused than during the COVID-19 pandemic.

Moments of joy with Dr. Fauci during our fireside chat.
 
AMIA Fireside Chat
Top row (L to R): Dr. Anthony Fauci, Dr. Patricia Flatley Brennan
Bottom row: Dr. Eneida Mendonça, Chair of the AMIA 2020 Scientific Program Committee

During the hour spent with Tony, I was reminded that engaging with domain experts can elevate awareness of where biomedical informatics challenges exist and the potential solutions that could have a broad impact. Taking part in this event with a giant in the field, like Dr. Fauci, was like taking a tour through the fields of microbiology, immunology, chemistry, pharmaceutical development, public health, and science education, highlighting the many points of impact open to biomedical informatics interventions.

It was wonderful to be able to introduce AMIA to Dr. Fauci, and vice versa. Tony spoke passionately about the importance of data sharing — emphasizing that peer review brings trust to data, and that data should be shared in ways that people can easily access and use. In his closing remarks, Tony expressed his appreciation for the opportunity to talk with the biomedical informatics community and acknowledged the benefits of building bridges to learn from each other.

Sharing What We Learned Together

Shared with permission: evan.william.orenstein@emory.edu

Through this interaction with Tony, I developed a deeper sense of his passion for science as well as his confidence in science. In considering how to best understand the long-term effects of COVID-19, Tony advocated for the effective use of patient registries – an area where biomedical informatics could make considerable contributions. When asked about how to better infuse science into our educational system, he enthusiastically responded that introducing children to science and scientific concepts in early childhood can foster a lifelong love of science, adding that “science can be love at first sight!”

I learned that preparedness is more important than prevention when it comes to pandemics. I was inspired by many of his views, including that supporting local public health authorities is the best first step to strengthening the national public health infrastructure. Finally, I developed a new perspective on the importance of scientific communications during emergencies and the challenges that can emerge when mixed messages and differing perspectives create confusion and uncertainty. 

The AMIA audience also shared what they learned from this session. Dr. Fauci’s clear explanation of the current trend that 75 percent of emerging infections originate through zoonotic transmission (i.e., disease that is passed from animals to humans) put into perspective his advice to prepare for — not try to prevent future pandemics. As one AMIA attendee offered, “It takes everyone to beat back this pandemic, and informatics has a role to play.” Another attendee shared of learning about new opportunities for biomedical informatics in global health.

As two of the 27 Institute and Center Directors at NIH, Tony and I share many responsibilities and have many opportunities to collaborate. Certainly, our mutual regard provides a strong platform for a discussion. What I didn’t expect from this discussion was to walk away with new insights about the importance of NLM’s support for open data, data sharing, and outreach to the public through our highly trusted information resources. I am delighted that we may have inspired AMIA attendees to answer some of the many challenges Tony described in guiding science and society through this pandemic.

Bridges are built by the concerted efforts of many people.

For this event, the AMIA Board of Directors brainstormed to come up with a set of questions that allowed for a lively discussion. AMIA members posed additional questions through a crowdsourcing strategy. Staff from NLM, NIAID, and AMIA collaborated to coordinate logistics, technology, messaging, and outreach to support the success of this conversation between two colleagues.

Did you attend the fireside chat at AMIA with Dr. Fauci? If so, what new planks on the bridge of your life did you discover?

Dr. Isaac Kohane: Making Our Data Work for Us!

Last weekend, Isaac Kohane, MD, PhD, FACMI, Marion V. Nelson Professor of Biomedical Informatics, and Chair of the Department of Biomedical Informatics at Harvard Medical School received the 2020 Morris F. Collen Award of Excellence at the AMIA 2020 Virtual Annual Symposium. This award – the highest honor in informatics – is bestowed to an individual whose personal commitment and dedication to medical informatics has made a lasting impression on the field.

Throughout his career, Dr. Kohane has worked to extract meaning out of large sets of clinical and genomic data to improve health care. His efforts mining medical data have contributed to the identification of harmful side-effects associated with drug therapy, recognition of early warning signs of domestic abuse, and detection of variations and patterns among people with conditions such as autism.

As the lead investigator of the i2b2 (Informatics for Integrating Biology & the Bedside) project, a National Institutes of Health-funded National Center for Biomedical Computing initiative, Dr. Kohane’s work has led to the creation of a comprehensive software and methodological framework to enable clinical researchers to accelerate the translation of genomic and “traditional” clinical findings into novel diagnostics, prognostics, and therapeutics.

Dr. Kohane is a visionary with a motto:  Make Our Data Work for Us! Please join me in congratulating Dr. Kohane, recipient of the 2020 Morris F. Collen Award of Excellence.

Hear more from Dr. Kohane in this video.

Video transcript (below)

The vision that has driven my research agenda is that we were not doing our patients any favors by not embracing information technology to accelerate our ability to both discover new findings in medicine, and to improve the way we deliver the medicine.

What does “make our data work for us” mean? It means that let’s not just use it for the real reason most of it is accumulated at present, which is in order to satisfy administrative or reimbursement processes. Let’s use it to improve health care.

Using just our claims data, we can actually predict – better than genetic tests – recurrence rates for autism. It’s the ability to show, with these same data, that drugs used for preventing immature birth in the genetic form are just as effective as those that are brand name; 40 times as expensive. It’s, as we’ve seen most recently, the ability to pull together data around pandemics within weeks, if and only if, we understand the data that’s spun off our health care systems in the course of care.

And finally, as exemplified by work on FHIR, which was funded by the Office of the National Coordinator and then the National Library Medicine, the ability to flow the data directly to the patient to finally allow patients’ access to their data in a computable format to allow decision support for the patient without going through the long loop of the health care system.

Because the NIH and NLM have invested in working on real-world sized experiments in biomedical informatics, on supporting the education of the individuals who drive those projects, and in supporting the public standards that are necessary for these projects to work and to scale, they’ve established an ecosystem that now is able to deliver true value to decision makers, to clinicians, and now to patients, as we’re seeing with a SMART on FHIR implementation on smartphones.

So, for those of you — the biomedical informaticians of the future who are clinicians — I strongly recommend that you don’t wait for someone else to fix the system. You have the most powerful tools to affect medicine, information processing tools. So, don’t wait to get old. Don’t wait to be recognized. You have the tools. Get in there, help change medicine. We all depend on you!